The proposed project is a secondary analysis of a unique data set from a geriatric health promotion project intended to improve the health and well-being of community dwelling adults over the age of 75 years. The randomized trial employed a gerontological nurse practitioner (GNP) model of preventive care that featured an initial in-home comprehensive health assessment of physical (including dental), social, emotional, and environmental domains and regular follow-up visits over a three year intervention period. The data set presents a unique opportunity to investigate longitudinal dental service utilization patterns and related oral health outcomes within a rich context of general health, well-being and environmental data available on each participant. The overall objective of the secondary data analysis is to evaluate the effectiveness of a community based nurse practitioner intervention targeting the older-old (age 75+) to stimulate appropriate dental service utilization and improve oral health outcomes. Specifically, we plan to: l) describe dental utilization patterns and oral health outcomes over a three year period of time in a sample of older-old adults; 2) evaluate the degree to which the GNP intervention influenced patterns of dental service use and oral health outcomes; and 3) determine socioeconomic, general health and well-being, and need correlates of longitudinal dental service use and oral health outcomes. The study sample consists of 414 individuals at baseline, including 212 control group and 202 intervention group subjects. Participants completed baseline, 12-, 24-, and 36-month in-home personal interviews as well as telephone interviews every four months. Intervention group subjects received an annual comprehensive assessment and follow-up visits every 4-months. Using a model of dental service use and oral health outcomes based on the work of Andersen, et. al., we plan to examine the pooled cross-section time-series data using multiple regression techniques. We propose to estimate a three-equation system using a modified version of the two-stage estimator for simultaneous equation models with discrete and limited endogenous variables. Over 13 million Americans are over 75 years of age. Oral diseases present a significant burden on the older population. Barriers to dental care persist for subgroups of older persons, especially those with low incomes, less education, belonging to a minority group or being in poor health. If shown to be effective, the GNP intervention would be a relatively inexpensive model to improve oral health outcomes in older adults. This research will also improve our understanding of the natural history of oral health outcomes in relation to patient risk factors, oral diseases and impairments, general health and well-being, and dental utilization behaviors.